特发性腹膜后纤维化17例诊治分析

目的：提高特发性腹膜后纤维化（IRF）的临床诊治水平。方法：回顾性分析我院近10年收治的17例IRF的临床资料。结果：腹痛、腰背痛、腹膜后包块及输尿管梗阻为主要临床表现。腹部CT检查对于腹部肿块和脏器粘连比B超敏感，但合并肾积水及输尿管病变者则以B超最有优势。术前诊断准确率为88．24％。15例合并输尿管梗阻，行输尿管松解、大网膜包裹移位术；2例合并肾动脉狭窄，行。肾动脉松解术、IRF包块切除术。1例术后死于心肌梗死，16例临床治愈。结论：IRF无特异性临床表现，术前诊断主要依据影像学检查，确诊需手术和病理学检查，治疗以解除尿路梗阻为主。

Idiopathic retroperitoneal fibrosis:A clinical analysis of 17 cases

Objective:To investigate the clinical diagnosis and treatment for idiopathic retroperitoneal fibrosis(IRF).Methods: The clinical data of 17 IRF cases were analyzed retrospectively from our hospital during recent 10 years.Results: The main clinical manifestations of IRF included abdominal pain,lower backache,(retroperitoneal) mass and ureteral obstruction.For the masses in retroperitoneal space and adhesion of abdominal(organs),CT was more sensitive than B-ultrasonography.However,for the hydronephrosis and lesions in ureter,B-ultrasonography was the first choice.Preoperative correct diagnosis was established in 88.24% of cases.(Ureterolysis) and wrapping up with the omentum were performed in 15 cases with ureteral obstruction.Two cases(suffering) from renal artery(RA) stenosis were relieved with arteria renalis lysis.Sixteen cases were cured and one case died from myocardial infarction postoperatively.Conclusion: IRF has nonspecific clinical manifestations.The preoperative diagnosis depends on the image characteristics and the final confimation depends on pathological(examination).The IRF should be treated appropriately with relief of the urinary tract obstruction.